Optimizing the resection volume to maximize clinical benefits and minimize postoperative deficits is crucial to neurosurgeons and their patients. While conventional magnetic resonance imaging (MRI) provides surgical planning guidance by visualizing the relationship between the pathology and nearby structures, it does not show brain function. Functional MRI (fMRI) can supplement invasive tests to determine hemispheric dominance and localize eloquent brain functions and serves as a useful adjunct in surgical planning. To provide an accurate answer to the clinical query, expertise is required to define the most appropriate task and image post-processing decisions. Evidence-based guidelines for these aspects are required to enable the implementation of fMRI as a routine clinical test beyond specialized centers. Recently, fMRI has been shown to provide localizing information for more complex cognitive operations in neurosurgical settings, helping to minimize disruption of whole brain networks following neurosurgery. Furthermore, fMRI has been utilized in other branches of neurosurgery, paving the way for personalized stereotactic functional neurosurgeries for movement and psychiatric disorders.